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COVID-19 大流行期间的学习过程有效性:通过培训内镜下袖状胃切除术的内镜医师来进行远程监考高级内镜技能。

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure.

机构信息

Division of Gastrointestinal Endoscopy, ABC Medical School, São Paulo, Brazil.

Diagnostic and Therapeutic Gastroenterology Amazon Region, Puyo, Ecuador.

出版信息

Obes Surg. 2021 Dec;31(12):5486-5493. doi: 10.1007/s11695-021-05757-4. Epub 2021 Oct 18.

Abstract

BACKGROUND AND AIMS

The COVID-19 pandemic has led health institutions to cancel many of the activities including training in different fields. Most practices and training programs have been encouraged to use teleproctoring as an alternative method to enhance physician's ability and assure training. We aimed to evaluate remote training program for endoscopy sleeve gastroplasty (ESG).

METHODS

Ten consecutive patients underwent an endoscopic sleeve gastroplasty procedure guided by a proctor expert using an online platform. A stepwise approach was created to assure skill acquisition.

RESULTS

All cases were safely performed with no serious adverse events under teleproctoring. The average surgical and suturing times significantly decreased during the training model. From the first 5 cases to the last 5 ones, the endoscopic procedure time decreased from 120 to 93.4 min while suturing time from 92.8 to 68.4 min. The effect size was large in both cases, and the changes were meaningful according to the fitted learning curves.

CONCLUSIONS

The proposed teleproctoring program was effective to deliver advanced endoscopic skills such as endosuturing for ESG, despite the restrictions imposed by the COVID-19 pandemic.

摘要

背景和目的

COVID-19 大流行导致医疗机构取消了许多活动,包括各个领域的培训。大多数实践和培训计划都被鼓励使用远程监督作为增强医生能力和保证培训的替代方法。我们旨在评估内镜套扎胃减容术(ESG)的远程培训计划。

方法

连续 10 例患者在专家监督下使用在线平台进行内镜套扎胃减容术。创建了一个逐步方法来确保技能的获得。

结果

在远程监督下,所有病例均安全进行,无严重不良事件。在培训模式下,手术和缝合时间均显著缩短。从前 5 例到后 5 例,内镜手术时间从 120 分钟减少到 93.4 分钟,缝合时间从 92.8 分钟减少到 68.4 分钟。两种情况下的效果量都很大,根据拟合的学习曲线,变化具有意义。

结论

尽管受到 COVID-19 大流行的限制,但所提出的远程监督计划可有效提供高级内镜技能,例如 ESG 的内镜缝合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec8/8523006/f5a07fe4eb42/11695_2021_5757_Fig1_HTML.jpg

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